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  1. Eye Care / Optometry
  2. Process
  3. Billing review
Process · Billing review

Billing review

Billing starts with an encounter-linked service charge. The coordinator checks its description and amount, approves it when correct and records when it is invoiced. Payments are recorded against patients with their own date and reference. The team should reconcile those receipts to its payment or accounting system using that reference.

Step by step

  1. Review encounter Clinical Reviewer

    Clinical Reviewer completes the care review so billing staff can inspect the delivered service context.

    • Provides visit context for the charge
    • Updates Encounters, Clinical notes
    ApprovalA person approves before the work moves on.
  2. Review charge Clinical Coordinator

    Clinical Coordinator checks the draft charge against the encounter and approves it for invoicing or voids an incorrect draft.

    • Decides whether the service amount may be invoiced
    • Updates Charges, Encounters
    ApprovalA person approves before the work moves on.
  3. Record payment Admin

    Clinical Coordinator checks the received amount and reference; Admin confirms the patient receipt when the payment source confirms it.

    • Tracks the patient receipt and confirmation
    • Updates Payments, Patients

Where it usually breaks

And how to keep it from happening.

  • A draft charge can refer to the wrong visit. Check the patient and service context through its encounter.
  • An approved charge and an invoiced charge are different states. Use the latter only after invoice issue.
  • A payment record belongs to a patient, while a charge belongs to an encounter. Reconciliation needs the external reference and the clinic's financial process.
  • A refunded receipt should retain its original reference so Admin can trace the return.
Clinical Coordinator
Owns charge review and reads receipts.
Admin
Manages payment records.
Clinical Reviewer
Owns the separate care review decision.

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